Organization
CANNON MEMORIAL HOSPITAL
Active
Parent organization
CANNON MEMORIAL HOSPITAL
Other names
CANNON FAMILY PRACTICE - LIBERTY, AnMed Primary Care-Liberty
Organization subpart
Yes
Provider details
NPI number
Legal business name
CANNON MEMORIAL HOSPITAL
Authorized official
MICHAEL CUNNINGHAM (CEO)
(864) 898-1133
Entity
Organization
Contact information
Practice address
105 LIBERTY BLVD, LIBERTY, SC 29657-1641
(864) 843-9213
(864) 843-5634
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 897-8280
(864) 897-8281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2510
—
SC
Enumeration date
07/26/2006
Last updated
01/23/2025
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